The efficacy of ranitidine bismuth citrate, amoxicillin and doxycycline or tetracycline regimens as a first line treatment for Helicobacter pylori eradication

Background: The eradication rates of Helicobacter pylori (H. pylori) clearly decreased with standard PPI-based triple therapies. Aim: To assess the efficacy of two different triple therapies consisting of ranitidine bismuth citrate-amoxicillin-doxycycline and ranitidine bismuth citrate-amoxicillin-tetracycline combinations as a first line treatment option. Methods: One hundred and fifteen consecutive dyspeptic patients in whom H. pylori infection was diagnosed for the first time were enrolled in this study. The patients were randomized into two groups. Group I (n=57) was assigned to receive a 14-day triple therapy consisting of ranitidine bismuth citrate 400 mg (b.i.d), amoxicillin I g (b.i.d) and doxycycline 100 mg (b.i.d). Group 2 (n=58) was assigned to receive a 14-day triple therapy consisting of ranitidine bismuth citrate 400 mg (b.i.d), amoxicillin I g (b.i.d) and tetracycline 500 mg (q.i.d). Results: The eradication was achieved in 45.7% (21/46) and 40.8% (20/49) of the patients in group I and group 2, according to per protocol analysis. The intention-to-treat eradication rates were 36.8% (21/57) and 34.5% (20/58) in group I and group 2, respectively. Conclusions: Two-week therapy with neither ranitidine bismuth citrate-amoxicillin-doxycycline nor ranitidine bismuth citrate-amoxicillin-tetracycline is adequately effective for H. pylori eradication as a first line therapy, (C) 2008 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.